J Trauma
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Reconstructive microsurgery has been part of the treatment for severe tibial fractures for over 20 years. ⋯ In the past 5 years, the flap survival rate and the microvascular free flap operation methods were the same as they were in the 1980s, but the methods for enhancing the fracture union or reconstructing the bone defect has changed.
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To determine the ability of an externally applied continuous negative abdominal pressure device (CNAP) to reverse the effects of elevated intra-abdominal pressure on the central nervous and cardiovascular systems. ⋯ Acutely elevated IAP causes a significant increase in ICP and impaired cardiovascular and pulmonary function. Abdominal decompression remains the standard of care for abdominal compartment syndrome. However, in patients in whom an increased IAP does not require surgical decompression, the results of this study suggest that externally applied CNAP may be of value.
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Early detection of vascular impairments after free tissue transfers are essential to prevent flap failure. Near-infrared spectroscopy showed good promise to monitor flaps at deep levels successfully without being invasive. The purpose of this study was to test whether the INVOS 3100 cerebral oxymeter is capable of detecting circulatory impairments. ⋯ This study, designed to test less-expensive equipment, was able to measure absolute values, and was not prone to interference caused by probe movement, providing information on the oxygenation profile accurately and noninvasively, and distinguishing between arterial and venous occlusion.